Winning the battle against weeds is crucial for sustainable rice (Oryza sativa L.) production in sub-Saharan Africa (SSA), where weeds remain a leading cause of yield losses and continue to threaten the livelihoods of millions of smallholder farmers, with farms below one hectare. This review evaluates the dynamic landscape of weed control strategies by examining weed ecology, the limitations of traditional hand weeding, and the growing risks associated with overreliance on herbicides including escalating health concerns, environmental impacts, and the rapid rise of herbicide resistance. The central finding advanced in this review is that, despite the proven potential of integrated weed management (IWM) to provide sustainable and resilient weed control, its widespread adoption remains considerably low. Key barriers include weak extension services, low farmer awareness, and insufficient policy support which collectively prevent timely and effective uptake of diversified weed control strategies. While approaches such as biological control, cover cropping, crop rotation, and precision tools old promise, they remain underutilized without strong institutional backing. Drawing from case studies across the region, the review argues that IWM could deliver the most resilient and context appropriate results if embedded within robust advisory systems and supportive incentives. The paper concludes with recommendations to strengthen extension capacity, promote farmer centered innovation, and align policies to accelerate sustainable, scalable adoption of IWM across SSA.